Advanced Practice Professional Issue Forum 2010 Report

Advanced Practice
Professional Issue Forum 2010
Report & Recommendations
Prepared by: Marcia Finlayson, PIF Facilitator
With input from Maureen Coulthard, Janet Craik and Christiane DesLauriers
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Introduction
At the 2009 annual conference in Ottawa, the Canadian Association of Occupational Therapists
(CAOT) held a Professional Issue Forum (PIF) focusing on advanced practice in occupational
therapy in Canada. The event resulted in a series of recommendations to the CAOT Board. One
of the key recommendations was that the members of the Board convene a Task Force to
continue to develop an understanding of advanced practice in Canada and move toward
developing a definition that could be used across the country. The Board accepted this
recommendation, convened a task force and working group, and planned a second PIF so that
the members of this group could share their efforts and obtain feedback from CAOT members
at the 2010 annual conference in Halifax.
The forum was held at the Halifax Marriott Habourfront Hotel on May 28 th 2010 from 8:30 am11:30 am. The event was facilitated by Marcia Finlayson and Maureen Coulthard. There were
42 participants representing a mix of clinicians, academics, regulators, students and staff of
professional organizations. The purposes of the 2010 advanced practice PIF were to:
 Review key findings and recommendations from 2009 advanced practice PIF,
 Review the tasks and process used by the advanced practice task force and working
group,
 Highlight findings from the survey conducted by the advanced practice task force and
working group,
 Debate three potential ways of framing advanced practice in occupational therapy that
have emerged from the work to date in order to guide future CAOT efforts.
This report will summarize the 2010 PIF, the discussions arising, and the recommendations that
stemmed from those discussions.
Key Findings and Recommendations from the 2009 advanced practice PIF
Marcia Finlayson set the stage for the 2010 advanced practice PIF by summarizing the report of
the 2009 event (Finlayson & Craik, 2009). She explained that the 2009 PIF was used to explore
the meanings & key issues related to advanced practice; exchange information & perspectives
about the factors influencing advanced practice, and develop recommendations for CAOT about
the next steps the organization should consider in terms of addressing advanced practice in the
profession.
These objectives were achieved in 2009 by reviewing how the term advanced practice was
currently being used in the profession, how it is being used in nursing and physiotherapy, and
by identifying key definitional challenges from the perspective of three stakeholder groups
(clinicians, managers, regulators). These perspectives were shared through a panel
presentation followed by small group discussions.
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Upon conclusion of the 2009 advanced practice PIF, it became clear that Canadian occupational
therapists needed a national vision of what advanced practice could and should be in Canada
and that this definition needed to:
 Be portable and applicable across the provinces and territories despite regulatory
variability,
 Acknowledge the continuum of skills and the diversity of practice areas,
 Support career laddering in the profession, and
 Be useful to employers and educators to prepare for and support AP in occupational
therapy.
As a result, the final report from the 2009 advanced practice PIF recommended that CAOT
develop a multi-stakeholder task force to:
 Conduct an environmental scan and needs assessment of advanced practice in Canada,
 Use findings to sort out key issues and develop a national definition of advanced
practice for occupational therapy, and
 Determine the educational requirements for advanced practice in Canada.
Tasks and Process Used by the Advanced Practice Task Force and Working Group
Maureen Coulthard, Director of Standards at CAOT, explained how CAOT used the 2009
advanced practice PIF report to guide the development of a pan-Canadian task force and
working group. The group included representatives from clinical practice, administration,
ACOTRO, CAOT, university faculty, provincial government human resources planning, and
representatives from the Canadian Nursing Association and the Canadian Physiotherapy. A full
list of members of the Task Force and Working Group is provided in Appendix A.
The task force and working group regularly conducted teleconference meetings and e-mail
communications between December 2009 and May 2010. Members reviewed background
documents related to advanced practice details available from Christiane Des Lauriers,
developed survey questions for the environmental scan and needs assessment, and developed
plans for 2010 PIF. During the course of their efforts, many questions arose for the members of
the task force and working group. Some of these questions included:




How do we differentiate among advanced practice, proficient practice (as defined by the
Occupational Therapy Profile) and specialized practice?
How will defining advanced practice in occupational therapy contribute to concerns
within and outside of the profession about “credential creeping”?
In the process of defining advanced practice in occupational therapy, how do we
balance protection of the public with our professional desire to continue to improve
services by advancing the profession?
How would advanced practice in occupational therapy affect recruitment and retention
of occupational therapists?
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Many other issues and concerns were identified as the task force and working group continued
their efforts. Ultimately, the members expressed concerns that rushing to address such an
important issue was not in the best interest of the profession in Canada since any decisions that
were made would have long lasting effects. Consequently the task force and working group
decided that preparing a definition prior to the 2010 advanced practice PIF was not realistic and
that focusing on the environmental scan and needs assessment was more appropriate. They
pursued this task by developing a CAOT member survey with the understanding that the
information generated would serve as a foundation for further discussion. The guiding
questions of the survey were:
• How prevalent is advanced practice in Canada?
• What do occupational therapists in advanced practice positions do?
• Are there differences between occupational therapists who are in advanced practice
positions and those who are not?
• Do CAOT members feel a definition of advanced practice is important?
• What do CAOT members perceive as the potential benefits of defining advanced
practice in occupational therapy?
Survey Findings
Methods: The questions on the self-reported survey were developed iteratively and
collaboratively by the task force and working group members, with input from Marcia Finlayson
and Maureen Coulthard. Two pre-tests were done to ensure that the wording of items and
their responses was clear and comprehensive.
Once the survey items were determined, it was translated into French. Both versions of the
survey were administered through Fluid Survey and also made available through a weblink on
the CAOT website. CAOT members were notified about the survey and invited to participate
through a e-mail blast. The survey was available on-line for three weeks in late March and early
April of 2010. Copies of the surveys are provided in Appendix B.
Survey responses were analysed using descriptive statistics and bivariate comparisons (t-tests,
chi-squared tests). Questions that provided participants with the option to provide comments
were analyzed by categorizing similar responses together to identify common themes.
Findings: A total of 619 members responded to the survey (582 in English, 37 in French). Table
1 provides a demographic summary of respondents.
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Table 1: Participants in the AP Questionnaire (N=619)
Variable
Age
Gender
Highest academic degree
Any specialist certification or
credential?
Did being an occupational therapist
make you eligible for your current
position?
Primary job responsibility
Employers CIHI category
Response options
20 - 29 years
Count
%
81
13.1%
30 - 39 years
40 - 49 years
50 - 59 years
60+ years
Male
Female
168
180
155
32
43
573
27.3%
29.2%
25.2%
5.2%
7.0%
93.0%
Certificate/Diploma
Bachelor's
Master's (entry level professional)
Master's (post-professional)
Doctorate
No
24
392
83
97
20
454
3.9%
63.6%
13.5%
15.7%
3.2%
75.4%
Yes
Yes
No
Not sure
Direct service provider
Educator
148
596
4
9
429
29
24.6%
97.9%
.6%
1.5%
70.3%
4.8%
Researcher
Manager
Professional leader/coordinator practice
leader
12
35
55
2.0%
5.7%
9.0%
Association/Government/Para Government
10
1.6%
40
143
80
31
31
1
68
24
42
40
31
32
32
6.6%
23.4%
13.1%
5.1%
5.1%
.2%
11.1%
3.9%
6.9%
6.5%
5.1%
5.2%
5.2%
2
.3%
Other
General hospital
Rehabilitation hospital / facility
Mental health hospital / facility
Residential care facility
Assisted living residence
Community health centre
Visiting agency / business
Group professional practice / clinic
Solo professional practice / clinic
Post-secondary education institution
School or school board
Association / government / para-government
Industry / manufacturing and commercial
5
Region
Type of community in which you
live
Current job designated or classified
as AP
Other - employer type not described
N/A
Unknown
Newfoundland
51
1
2
15
8.3%
.2%
.3%
2.5%
Nova Scotia
New Brunswick
Prince Edward Island
Quebec
Ontario
Manitoba
35
32
5
31
237
26
5.8%
5.3%
.8%
5.1%
39.0%
4.3%
Saskatchewan
Alberta
British Columbia
Yukon
North West Territories
Nunavut
21
87
105
0
2
0
3.5%
14.3%
17.3%
.0%
.3%
.0%
Outside of Canada
Urban or suburban
Small town
Rural
Remote
No
Not sure
Yes, designated by my employer
Yes, classified by my union
Yes, classified by another authority
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481
70
55
3
445
117
27
7
11
1.8%
79.0%
11.5%
9.0%
.5%
73.3%
19.3%
4.4%
1.2%
1.8%
Across all respondents, 45 indicated that their position was designated as advanced practice.
The designation was made by job title and job description (55%), by job description only (31%),
and by experience (4%). The remaining individuals did not indicate how their position was
designed as advanced practice.
Using t-tests and chi-squared tests, several comparisons were made between those
respondents who reported being in an advanced practice and those respondents who were not.
No statistically significant differences were found between the two groups in terms of age,
gender, or academic degree. Individuals who reported being in an advanced practice position
were less likely to report that their primary job responsibility was direct service provision and
more likely to report that it was being a professional leaders / coordinators (p=0.01). They
were also more likely to have an additional specialist credential (p<0.0001).
Comparisons were also made across the specific responsibilities of respondents’ positions
according to their job descriptions (self-reported). Respondents were provided with a list of
eleven potential responsibilities and asked to check all that applied to their position. When
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comparing individuals who reported being in an advanced practice position to individuals who
did not, no significant differences were found in the proportion of each group who:
 Provided direct occupational therapy services to clients (individuals or groups);
 Contributed to the analysis or development of standards, quality initiatives, policies and
procedures, and/or practice guidelines;
 Developed and delivered educational programs for others (clients, caregivers, students,
public or other members of the multidisciplinary team);
 Led or actively participated in the development and implementation of original research
projects;
 Led or actively participated in transferring research knowledge into the practice setting;
 Disseminated knowledge through publication (peer-reviewed, professional magazine or
other);
 Provided professional leadership to develop and advance the field;
 Supervised and trained other staff; or
 Managed budgets.
Consequently, the findings regarding job classification and job responsibilities indicate that the
difference between occupational therapists who identify being in an advanced practice position
are different from those who do not in terms of their primary job responsibility, not the overall
range of duties performed.
Survey respondents were also asked about the importance of defining advanced practice for
occupational therapy in Canada, regardless of the designation of their current position. Seventy
percent of respondents said it was very important or important (31% and 39%, respectively).
An additional 26% reported that developing a definition was somewhat important, and the
remaining 4% reported that it was not important. These importance ratings did not vary
significantly by age, gender, specialist credential, or years in practice. Nevertheless, individuals
who were currently unsure of their position designation (i.e., advanced practice or not) were
more likely to report that developing a definition was at least somewhat important (p=0.03).
All respondents who reported that developing a definition was at least somewhat important
were asked to rate the extent to which such a definition would offer added value for the
profession, employers, the public and policy makers. A four-point rating system was used:
none, low, moderate and high.
Across respondents, the top benefits for the profession were identified as being:
 Recognition (70%)
 Acknowledgement of advanced practice (66%)
 Specialization opportunities (65%)
 Career laddering opportunities (51%)
The top benefits for employers were identified as being:
 Highly trained occupational therapy workforce (52%)
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

Occupational therapy workforce that can fulfill broader range of responsibilities (48%)
More autonomous occupational therapy workforce (42%)
The top benefits for the public were identified as being:
 Access to highly trained workforce (51%)
 Greater access to most current evidence-based occupational therapy services (44%)
The top benefits for policy makers were identified as being:
 Highly trained occupational therapy workforce (46%)
 Occupational therapy workforce that can fulfill broader range of responsibilities (46%)
 Greater access to most current evidence-based occupational therapy services (45%)
The final question on the survey was open ended and invited respondents to add any additional
comments or concerns that they wished to express about advanced practice and the CAOT
efforts on this issue. Overwhelming, the comments thanked CAOT for bringing the issue
forward and noted that there is a critical need to define advanced practice since there is a lack
of understanding of this term and what it means both within and outside of the profession. At
the same time, respondents also expressed the need for caution as CAOT moves forward,
noting that it is critical that the process of defining advanced practice does not lead to a
devaluation of occupational therapy roles that are not designated as advanced practice.
Ultimately, the qualitative comments indicated both positive and negative perspectives on
advanced practice. On the positive side, advanced practice was seen as offering opportunities
for professional growth, public awareness, recruitment and retention benefits and career
laddering. On the negative side, concern was expressed about the potential to devalue the
work of occupational therapists not designated as advanced practice, whether financial
compensation would follow the title, and if advanced practice vacancies could be filled.
Concerns about regulation were also expressed. Respondents also noted that an advanced
practice designation must recognize and acknowledge clinical experience and credentials,
academic achievement, involvement in knowledge translation and the dissemination of
information and expertise, professional leadership, and the ability to critically analyze,
influence and develop policies and programs.
Discussion on the Ways of Framing AP in Occupational Therapy in Canada
During the last half of the forum, attendees were provided with three potential ways of framing
advanced practice in occupational therapy in Canada (i.e., as a specialist, as an extended scope
practitioner, as a global leader) (Appendix D). Attendees reflected on these options, discussed
them in small groups, and then shared their thoughts with the larger audience. Through these
discussions, the complexity, nuances and challenges of describing advanced practice were
reinforced. It became clear that none of the three potential ways of framing advanced practice
were fully satisfactory because of the many logistical and regulatory issues that each of them
could bring about. Attendees emphasized the need for CAOT to proceed cautiously and
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strategically as any decision will have long lasting impacts on the profession, consumers and
other stakeholders. They noted that although a definition of advanced practice may offer
benefits, there is also the risk of splintering an already small profession, devaluing therapists
who are not in advanced practice positions, and reducing access to occupational therapists
rather than improving it.
As the discussion continued, several key themes emerged. They were as follows:
1. CAOT must position the organization and the profession strategically in order to take
into account population needs, career laddering, and recognition. The organization
must be clear about the goal (s) of pursuing any activities related to advanced practice.
2. CAOT must be proactive and future oriented rather than reactive when it comes to
advanced practice (e.g., avoid pursuing advanced practice as a “catch up” because other
professions are doing it).
3. CAOT must remain aware of and sensitive to the potential risks and repercussions of
advanced practice both within and outside of the profession.
4. CAOT must acknowledge the differences in responding to the evolving systems in which
occupational therapists are working, addressing therapists’ individual needs and
motivations to advance within their own careers, and defining advanced practice. In
other words, CAOT must distinguish between advanced practice and advancing practice.
Final Recommendation for the CAOT Board
Upon conclusion of the 2010 advanced practice PIF, it was recommended that CAOT develop a
position statement to put forth a vision and set of core principles (rather than a definition) that
can guide future efforts related to advanced practice in occupational therapy in Canada.
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Appendix A: Members of the Advanced Practice Task Force and Working Group
TASK FORCE
Position
A
Sandra Bessler
Consultant
Tricia Dickson
Advanced Practice
Clinician
Registrar/CEO
College of Occupational
Therapists of BC
Director of Standards
CAOT
Kathy Corbett
Maureen Coulthard
(Committee Chair)
Background
Panel Member Advanced
Practice PIF 2009
Panel Member Advanced
Practice PIF
ACOTRO Representative
CAOT Representative
WORKING GROUP MEMBERSHIP/REPRESENTATION
Stakeholder Group
Regulatory Organization
Professional Association
Practice Leader
Clinician Representatives
Representative Contact
Name
Pat Edney
Nicola MacNaughton
Patti Erlendson
Lorna Bain
Administrator/ Employer
Jane Cox
Marlene Stern
Government
Other Professional Group
with AP Experience
Academic; Other
Professional Group with
AP Experience
Academic
ACOTUP
Title/Position
Susan Illmayer
Jossette Roussel
Associate Registrar, Alberta
President NBSOT
Practice Leader Vancouver
Clinician coordinator, allied health
educator, arthritis program,
Ontario
Clinician, lecturer, mentor , Ontario
Administration / professional
leader background,
Manitoba
Government Rep., British Columbia
CNA Ontario
Linda Woodhouse
PT Professor McMaster University
Liz Townsend
Susan Rappolt
OT professor – Dalhousie U
OT Professor – U of T
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Appendix B: Copies of the Advanced Practice Survey
Exploration of advanced practice in OT in Canada
Introduction
Across Canada and around the world, the term “advanced practice” is being used increasingly by
occupational therapists and their employers, and occupational therapy educators and regulators. To
date, there is no consensus about the meaning of advanced practice (AP) in occupational therapy. In
response, CAOT has initiated a project to examine AP in Canada. The ultimate goal of this work is to
develop a clear understanding of AP that can be shared across the country.
As a CAOT member, we are asking for your input for this project. The survey that follows will enable
the project team to determine:
· the extent to which CAOT members currently hold AP positions and if so, what the nature of these
positions are,
· how CAOT members characterize AP based on the current Canadian practice environments,
· whether defining AP is important from the perspective of CAOT members.
This survey will take you approximately 10 minutes to complete. It is divided into three parts:
Part 1: Demographic profile – This information will help us describe the characteristics of the survey
respondents, allow future comparisons across sub-groups who respond, and compare respondents to
the general CAOT membership.
Part 2: Environmental Scan of current AP positions – This information will allow us to describe the
current situation with respect to AP in Canada at this time (e.g., job titles and classification, settings in
which these positions exist, educational requirements, etc.)
Part 3: Factors that need to be further understood with respect to AP in occupational therapy in
Canada. This information will allow us to identify the most critical factors that occupational therapists
believe need to be addressed during on-going discussions about AP in occupational therapy in Canada.
Findings from this survey will be presented at the 2010 Professional Issues Forum at the CAOT
conference.
Part 1 - Demographic Profile
Question 1
What is your current age?
20 - 29
30 - 39
40 - 49
50 - 59
60+
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Question 2
Are you:
Male
Female
Question 3
What year did you graduate from your entry-level occupational therapy degree? (enter the year of
your graduation).
Question 4
What is your highest academic degree?
Certificate/Diploma
Bachelor's
Master's (entry level professional)
Master's (post-professional)
Doctorate
Question 5
In addition to your academic degree, do you hold any specialist certification or credential?
No
Yes, please identify:
Question 6
What is your current job title?
Question 7
Did being an occupational therapist make you eligible for your current position?
Yes
No
Question 8
Within your current job, what is your primary responsibility? (check one)
Direct service provider
Educator (major role as educator for a particular target group)
Researcher (major role is in knowledge development and dissemination of research)
Manager (includes first level management of a particular program through to senior most
management positions)
Professional leader/coordinator practice leader (direct service provider with a leadership role in
professional practice within an employment setting).
Association/Government/Para Government ( an organization or government that deals with
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regulation, advocacy, policy development, program development, research and/or the protection of
the public at a national, provincial/territorial or municipal level)
Other:
Question 9
Which of the following CIHI categories best describes your primary employer? (check one)
General hospital
Rehabilitation hospital / facility
Mental health hospital / facility
Residential care facility
Assisted living residence
Community health centre
Visiting agency / business
Group professional practice / clinic
Solo professional practice / clinic
Post-secondary education institution
School or school board
Association / government / para-government
Industry / manufacturing and commercial
Other - employer type not described
N/A
Unknown
Question 10
In what region do you currently work? (check one)
Newfoundland
Nova Scotia
New Brunswick
Prince Edward Island
Quebec
Ontario
Manitoba
Saskatchewan
Alberta
British Columbia
Yukon
North West Territories
Nunavut
Outside of Canada
Question 11
What term best describes the area in which you work? (check one)
Urban or suburban
Small town
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Rural
Remote
Part 2 - Environmental Scan
Question 12
Is your current job designated or classified as an advanced practice position?
No
Not sure
Yes, designated by my employer
Yes, classified by my union
Yes, classified by another authority (Please specify):
Question 13
Is your position designated or classified as advanced practice in the following (check one):
Job Title only
Job description only
Job title and job description
Other, please specify:
Question 14
What is the minimum academic degree requirement of your position?
Diploma
Bachelor's
Master's (entry level professional)
Master"s (post-professional)
Doctorate
Question 15
In addition to the minimum academic degree requirement, does your position also require
a certification, credential or additional advanced training?
No
Yes, requires advanced training either from my employer or another entity.
Yes, requires a certification or credential. Please identify:
Question 16
What are the specific responsibilities of your position according to your job description? (Check all
that apply)
Provide direct occupational therapy services to clients (individuals or groups).
Contribute to the analysis or development of standards, quality initiatives, policies and
procedures, and/or practice guidelines.
Develop and deliver educational programs for others (clients, caregivers, students, public or other
members of the multidisciplinary team).
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Lead or actively participate in the development and implementation of original research projects.
Lead or actively participate in transferring research knowledge into the practice setting.
Disseminate knowledge through publications (peer-reviewed, professional magazine or other).
Provide professional leadership to develop and advance the field.
Supervising and training other staff.
Manage budgets
Go beyond typical occupational therapy practice activities allowed in your province or territory.
Please give examples:
Question 17
Based upon your job description and responsibilities, do you believe that your position should be
designated or classified as an advanced practice position?
Not sure
No
Yes, please explain:
Question 18
What are the specific responsibilities of your position according to your job description ? (Check all
that apply)
Provide direct occupational therapy services to clients (individuals or groups)
Contribute to the analysis or development of standards, quality initiatives, policies and
procedures, and/or practice guidelines
Develop and deliver educational programs for others (clients, caregivers, students, public or other
members of the multidisciplinary team).
Lead or actively participate in the development and implementation of original research projects.
Lead or actively participate in transferring research knowledge into the practice setting.
Disseminate knowledge through publication (peer-reviewed, professional magazine or other)
Provide professional leadership to develop and advance the field.
Supervise and training other staff.
Manage budgets.
Go beyond typical occupational therapy practice activities allowed in your province or territory.
Please provide examples of such activities:
Part 3: Factors that need to be further understood with respect to AP in occupational therapy in
Canada.
Question 19
Do you feel that it is important for CAOT to develop a definition of AP for Canadian occupational
therapists?
1 Not important
2 Somewhat important
3 Important
4 Very important
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Question 20 - introduction
From your perspective, please rate the potential added value of having a Canadian definition of
advanced practice for occupational therapy in each of the following categories.
Question 20a
Please rate the extent to which a Canadian definition of advanced practice in occupational therapy
would offer added value for members of the profession in each of the following areas
1 None 2 Low 3 Moderate 4 High
Career development and laddering opportunities
Recruitment tool
Retention tool
Higher status within the workplace
Recognition of advanced capability
Expanded professional scope
Acknowledgement of advanced practice in OT
Specialization opportunities
Question 20b
Please rate the extent to which a Canadian definition of advanced practice in occupational therapy
would offer added value for employers of occupational therapists or private practitioners in each of
the following areas:
1 None 2 Low 3 Moderate 4 High
Recruitment tool
Retention tool
Highly trained occupational therapy workforce
Occupational therapy workforce that can fulfill broader range of
responsibilities
Occupational therapy workforce that can work more
autonomously
Better protection against poor quality occupational therapy
services
Employer recognition of advanced qualification and skills
Question 20c
Please rate the extent to which a Canadian definition of advanced practice in occupational therapy
would offer added value for clients and the general public in each of the following areas:
1 None 2 Low 3 Moderate 4 High
Access to highly trained occupational therapy workforce
Access to occupational therapists who can work more
autonomously
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1 None 2 Low 3 Moderate 4 High
Greater access to the most current, evidence-based occupational
therapy services
Better protection against poor quality occupational therapy
services
Question 20d
Please rate the extent to which a Canadian definition of advanced practice in occupational therapy
would offer added value for policy makers, managers, etc., in the systems in which occupational
therapists work (e.g., health care, schools, community programs, government,..) in each of the
following areas:
1 None 2 Low 3 Moderate 4 High
Recruitment tool
Retention tool
Highly trained occupational therapy workforce
Occupational therapy workforce that can fulfill broader range of
responsibilities
Occupational therapy workforce that can work more
autonomously
Greater access to the most current, evidence-based occupational
therapy services
Better protection against poor quality occupational therapy
services
Question 20e
Any other comments about the added benefit or potential issues and concerns with having a Canadian
definition for advanced practice in occupational therapy?
Thank you... for your time.
Findings from this survey will be presented at the 2010 Professional Issues Forum at the CAOT
conference.
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Exploration de la PA
Introduction
Le terme « pratique avancée » est utilisé de plus en plus par les ergothérapeutes et leurs employeurs,
de même que par les enseignants et les organismes de réglementation en ergothérapie au Canada et
à travers le monde. Jusqu’à présent, aucun consensus n’a été atteint quant à la définition et à la
signification de la pratique avancée en ergothérapie. Afin de pallier cette situation, l’ACE a entrepris un
projet en vue d’examiner la pratique avancée au Canada. Le but ultime de ce projet est de parvenir à
une vision claire de la pratique avancée pouvant être partagée à travers le Canada.
À titre de membre de l’ACE, nous vous invitons à participer à ce projet, en nous faisant part de vos
commentaires et de votre opinion sur cette question. Le sondage qui suit permettra à l’équipe du
projet de déterminer :
• la mesure selon laquelle les membres de l’ACE occupent actuellement des postes en pratique
avancée et, le cas échéant, les caractéristiques de ces postes;
• comment les membres de l’ACE caractérisent la pratique avancée en fonction des milieux de
pratique canadiens actuels;
• si les membres de l’ACE considèrent qu’il est important de définir la pratique avancée.
Il vous faudra environ 10 minutes pour répondre à ce sondage. Le sondage est divisé en trois parties :
Partie 1 : Profil démographique – ces renseignements nous aideront à décrire les caractéristiques des
répondants au sondage, à faire de futures comparaisons entre les sous-groupes de répondants et à
comparer les répondants à l’ensemble des membres de l’ACE.
Partie 2 : Analyse environnementale des postes actuels en pratique avancée – Cette information nous
permettra de décrire la situation actuelle en ce qui concerne la pratique avancée au Canada (p. ex.,
titre et classification des emplois, milieux dans lesquels ces postes existent, exigences en matière de
formation, etc.).
Partie 3 : Facteurs qui doivent être mieux compris en ce qui concerne la pratique avancée de
l’ergothérapie au Canada. Cette information nous permettra de cibler les principaux facteurs qui, selon
les ergothérapeutes, doivent être abordés lors des discussions sur la pratique avancée en ergothérapie
au Canada.
Les résultats de ce sondage seront présentés lors d’un forum sur une question professionnelle qui
aura lieu dans le cadre du Congrès 2010 de l’ACE.
Question 1
Quel âge avez-vous actuellement?
20 - 29
30 - 39
40 - 49
18
50 - 59
60+
Question 2
Êtes-vous :
un homme
une femme
Question 3
En quelle année avez-vous terminé votre formation de niveau d’entrée en exercice de l’ergothérapie?
(Inscrivez l’année d’obtention de votre diplôme).
Question 4
Quel est votre plus haut degré de scolarité?
Certificat/Diplome
Baccalaureat
Maitrise (niveau d'entree en exercice de la profession)
Maitrise (niveau post-professionnel)
Doctorat
Question 5
Mis à part votre diplôme universitaire, avez-vous d’autres attestations ou titres de spécialiste?
Non
Oui, veuillez préciser:
Question 6
Quel est le titre de l’emploi que vous occupez actuellement?
Question 7
Est-ce que le fait d’être ergothérapeute vous a rendu admissible à votre poste actuel?
Oui
Non
Question 8
Dans votre emploi actuel, quelle est votre principale responsabilité? (Cochez une seule réponse)
Fournisseur de services directs
Enseignant (role majeur à titre d'éducateur pour un groupe cible particulier)
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Chercheur (rôle majeur dans la production de connaissances et la diffusion de la recherche)
Gestionnaire (allant des postes de gestionnaires de premier niveau d'un programme donné aux
postes de cadres supérieurs)
Leader professionel/coordonnateur de la pratique/chef des services professionels (fournisseur de
services directs ayant un rôle de leadership associé à la pratique professionnelle, dans un milieu de
travail)
Association/organisme gouvernemental/organisme paragouvernemental (organisation ou
organisme gouvernemental chargé de réglementation, de la revendication, du développement de
politiques, du développement de programme, de la recherche ou de la protection du public, aux
échelons national, provincial/territorial ou municipal)
Autre, veuillez préciser:
Question 9
Laquelle des catégories de l’ICIS suivantes décrit le mieux votre principal employeur? (Cochez une
seule réponse)
Hôpital général
Hôpital/Établissement de réadaptation
Hôpital/Établissement de soins de santé mentale
Établissement de soins pour bénéficiaires internes
Résidence de soins assistés
Centre du santé communautaire
Agence de services/Enterprise de services
Pratique ou clinique professionnelle en groupe
Pratique ou clinique professionnelle en solo
Établissement d'enseignement postsecondaire
École ou commission scolaire
Association/organisme gouvernemental/organisme para-gouvernemental
Industrie manufacturière et commerciale
Autre - type d'employeur non décrit
S/O
Indéterminé
Question 10
Dans quelle région travaillez-vous actuellement? (Cochez une seule réponse)
Terre-Neuve
Nouvelle-Écosse
Nouveau-Brunswick
Île-du-Prince-Édouard
Québec
Ontario
Manitoba
Saskatchewan
Alberta
Colombie-Britannique
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Yukon
Territoires du Nord-Ouest
Nunavut
À l'extérieur du Canada
Question 11
Quel est le terme qui décrit le mieux la région dans laquelle vous travaillez? (Cochez une seule
réponse)
Région urbaine ou suburbaine
Petite ville
Région rurale
Région éloignée
Partie 2 – Analyse environnementale
Question 12
Votre emploi actuel est-il désigné ou classé comme un poste en pratique avancée?
Non
Incertain
Oui, dsigné par mon employeur
Oui, classé par mon syndicat
Oui, classé par une autre compétence (veuillez préciser):
Question 13
Votre emploi actuel est-il désigné ou classé comme un poste en pratique avancée face aux aspects
suivants (cochez une seule réponse) :
Titre du poste seulement
Description d'emploi seulement
Titre du poste et description d'emploi
Autre, veuillez préciser:
Question 14
Quel est le degré de scolarité minimal requis pour occuper votre poste?
Diplôme
Baccalauréat
Maîtrise (niveau d'entrée en exercice de la profession)
Maîtrise (niveau post-professionnel)
Doctorat
Question 15
Mis à part le degré de scolarité minimal requis pour votre poste, ce poste exige-t-il une attestation
professionnelle additionnelle, un titre professionnel additionnel ou une formation avancée
additionnelle?
Non
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Oui, mon employeur ou une autre entité exige une formation avancée pour ce poste
Oui, ce poste exige une attestation professionnelle ou un titre professionnel. Veuillez préciser :
Question 16
Quelles sont les responsabilités spécifiques de votre poste, selon votre description d’emploi? (Cochez
toutes les réponses qui s’appliquent)
Prestation de services directs d’ergothérapie aux clients (individus or groupes)
Participation à l’analyse ou à l’élaboration de normes, à des initiatives liées à l’amélioration de la
qualité ou à l’élaboration de politiques et procédures ou de lignes directrices relatives à la pratique
Conception et prestation de programmes éducatifs pour d’autres intervenants (clients, aidants,
étudiants, public ou autres membres de l’équipe multidisciplinaire)
Direction ou participation active à l’élaboration et à la mise en œuvre de projets de recherche
originaux
Direction ou participation active au transfert des connaissances dans le milieu de la pratique
Diffusion des connaissances par la publication d’articles (revues examinées par les pairs, journaux
professionnels ou autres)
Leadership professionnel pour le développement et l’avancement du domaine
Supervision et formation du personnel
Gestion des budgets
Réalisation d’activités dépassant le champ d’activité de l’ergothérapie sanctionné dans votre
province ou territoire. Veuillez donner des exemples de ce genre d’activités :
Question 17
Compte tenu de votre description d’emploi et de vos responsabilités, croyez-vous que votre poste
devrait être désigné ou classé comme un poste en pratique avancée?
Incertain
Non
Oui, veuillez expliquer:
Question 18
Quelles sont les responsabilités spécifiques associées à votre poste, selon votre description d’emploi?
(Cochez toutes les réponses qui s’appliquent)
Prestation de services directs d’ergothérapie aux clients (individus ou groupes)
Participation à l’analyse ou à l’élaboration de normes, à des initiatives liées à l’amélioration de la
qualité ou à l’élaboration de politiques et procédures ou de lignes directrices relatives à la pratique.
Conception et prestation de programmes éducatifs pour d’autres intervenants (clients, aidants,
étudiants, public ou autres membres de l’équipe multidisciplinaire)
Direction ou participation active à l’élaboration et à la mise en œuvre de projets de recherche
originaux
Direction ou participation active au transfert des connaissances dans le milieu de la pratique
Diffusion des connaissances par la publication d’articles (revues examinées par les pairs, journaux
professionnels ou autres)
Leadership professionnel pour le développement et l’avancement du domaine
22
Supervision et formation du personnel
Gestion des budgets
Réalisation d’activités dépassant le champ d’activité de l’ergothérapie sanctionné dans votre
province ou territoire. Veuillez donner des exemples de ce genre d’activités :
Partie 3 : Facteurs qui doivent être mieux compris en ce qui concerne la pratique avancée de
l’ergothérapie au Canada
Question 19
Croyez-vous qu’il est important que l’ACE élabore et adopte une définition de la pratique avancée pour
les ergothérapeutes canadiens?
1 Pas important
2 Un peu important
3 Important
4 Très Important
Question 20 - Introduction
Selon votre perspective, veuillez évaluer la valeur ajoutée éventuelle de l’adoption d’une définition
canadienne de la pratique avancée en ergothérapie, pour chacune des catégories suivantes.
Question 20a
Veuillez évaluer la mesure selon laquelle l’adoption d’une définition canadienne de la pratique
avancée en ergothérapie serait une valeur ajoutée pour les membres de la profession, pour chacun
des aspects suivants :
1 Aucune 2 Faible 3 Moyenne 4 Élevée
Développement de la carrière et possibilités de gravir les
échelons
Outil de recrutement de l’effectif
Outil de maintien de l’effectif
Statut plus élevé au sein du milieu de travail
Reconnaissance des compétences avancées
Élargissement du champ d’activité professionnel
Reconnaissance de la pratique avancée en ergothérapie
Possibilités de spécialisation
Question 20b
Veuillez évaluer la mesure selon laquelle l’adoption d’une définition canadienne de la pratique
avancée en ergothérapie serait une valeur ajoutée pour les employeurs d’ergothérapeutes ou pour les
ergothérapeutes exerçant en clinique privée, pour chacun des aspects suivants :
3
1 Aucune 2 Faible
4 Élevée
Moyenne
Outil de recrutement de l’effectif
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1 Aucune 2 Faible
3
4 Élevée
Moyenne
Outil de maintien de l’effectif
Main-d’oeuvre très spécialisée en ergothérapie
Main-d’oeuvre en ergothérapie pouvant assumer un plus
grand éventail de responsabilités
Main-d’oeuvre en ergothérapie pouvant travailler de manière
plus autonome
Meilleure protection contre les services d’ergothérapie de
mauvaise qualité
Reconnaissance des compétences et connaissances
avancées, par l’employeur
Question 20c
Veuillez évaluer la mesure selon laquelle l’adoption d’une définition canadienne de la pratique
avancée en ergothérapie serait une valeur ajoutée pour les clients et la population en général, pour
chacun des aspects suivants :
3
1 Aucune 2 Faible
4 Élevée
Moyenne
Accès à une main-d’oeuvre très spécialisée en ergothérapie
Accès à une main-d’oeuvre en ergothérapie pouvant
travailler de manière plus autonome
Plus grand accès à des services d’ergothérapie actuels et
fondés sur les preuves
Meilleure protection contre les services d’ergothérapie de
mauvaise qualité
Question 20d
Veuillez évaluer la mesure selon laquelle l’adoption d’une définition canadienne de la pratique
avancée en ergothérapie serait une valeur ajoutée pour les décideurs, les gestionnaires, etc., au sein
des systèmes dans lesquels les ergothérapeutes travaillent (e.g., services de soins de santé, écoles,
programmes communautaires, gouvernement,…), pour chacun des aspects suivants :
3
1 Aucune 2 Faible
4 Élevée
Moyenne
Outil de recrutement de l’effectif
Outil de maintien de l’effectif
Main-d’oeuvre très spécialisée en ergothérapie
Main-d’oeuvre en ergothérapie pouvant assumer un plus
grand éventail de responsabilités
Main-d’oeuvre en ergothérapie pouvant travailler de manière
plus autonome
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1 Aucune 2 Faible
3
4 Élevée
Moyenne
Plus grand accès à des services d’ergothérapie actuels et
fondés sur les preuves
Meilleure protection contre les services d’ergothérapie de
mauvaise qualité
Question 20e
Avez-vous d’autres commentaires sur les avantages ou les problèmes ou préoccupations possibles face
à l’adoption d’une définition canadienne de la pratique avancée en ergothérapie?
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Appendix D: Three ways of framing advanced practice in occupation therapy
The following descriptions were provided to the PIF participants to elicit discussion about the
potential ways to frame advanced practice in occupational therapy in Canada. These
descriptions were developed based on the background documents that were reviewed by the
Task Force and Working Group, as well as the findings of the survey.
Description #1 - Specialist
Advanced Practice Occupational Therapists have additional post-graduate training or
credentials that qualify them in a specific domain of occupational therapy (e.g., hand therapy,
driver specialist, environmental design). They are proficient practitioners as outlined in the OT
Profile and work within the regulated scope of practice. They are specialists and are sought out
by others for consultation because of their expertise. They demonstrate exceptional
professional reasoning and judgment and may be involved in research, knowledge translation,
program and policy development within their area of specialty.
Description # 2- Extended Scope
Advanced Practice Occupational Therapists have received additional training in order to
perform duties that extend beyond the regulated scope of occupational therapy practice.
Because of these duties, they have extensive levels of independence, autonomy and
accountability. They are proficient practitioners as outlined in the OT Profile. They are sought
out by others for consultation because of their expertise. They demonstrate exceptional
professional reasoning and judgment and may be involved in research, knowledge translation,
program and policy development within their area of specialty. They provide education among
professional and intersectoral groups.
Descriptor #3 – Global Leader
Advanced Practice Occupational Therapists have additional knowledge and competencies that
qualify them in a specific domain of occupational therapy. Their area of expertise may include
direct care, program development, administration, policy development, education or research.
They work beyond proficient practice as outlined in the OT Profile and within regulated scope
of practice. They demonstrate exceptional professional reasoning, judgment and expertise.
They excel in explaining and using theory, drawing on experience, and building research and
intersectoral collaboration to meet complex client, policy and program needs.
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Reference list
Brenchley, C. (December 10 2009), Occupational Therapy Scope of Practice Review.
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Bressler, S. Craik, J., Finlayson, M., Dickson, P. & Rollin, F. (2009) Report and
Background Discussion on Advanced Practice in Occupational Therapy .
Proceedings from Advanced Practice Professional Issues Forum: CAOT
Conference.
Canadian Association of Occupational T herapist (2007) Profile of Occupational
Therapy Practice in Canada. Retrived from CAOT database .
Canadian Association of Occupational Therapist (2009) Membership Profile Survey
2009-2010.
Canadian Institute for Health Information (2009) Occupational Therapist Database
Data Dictionary Version 2.0.
Canadian Nurses Association (2007) Advanced Nursing Practice: Position
Statement.
Canadian Nurses Association (2008) Advanced Nursing Practice: A National
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Clampin, A. (2009) Project Specification – Advanced Practitioner Scheme Phase 2:
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27
College of Nurses of Ontario (2003) Acute Care/Specialty Nurse Practitioner: Policy
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Mavrommatis, S. (2008, April) Changing Health Care Landscape Set to Challenge
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Scott, J. *[email protected]+. “RE: Advanced Practice Initiative” private email
message to Maureen Coulthard [[email protected]]. 6 January 2010 .
Yo-Yo Consultancies (2009), Final Report: Milestone Three of the COT Advanced
Capability Scheme Project.
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